Lichen Planus

Chapter 77 Lichen Planus



INTRODUCTION



Description: Lichen planus is a non-neoplastic epithelial disorder that affects glabrous skin, hair-bearing skin and scalp, nails, mucous membranes, or the oral cavity and the vulva.

Prevalence: Unknown, but relatively common.

Predominant Age: 30 to 60 years.

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Unknown. Proposed—autoimmune disorder, possibly initiated by certain drugs such as beta blockers, angiotensin-converting enzyme (ACE) inhibitors.

Risk Factors: None known.


CLINICAL CHARACTERISTICS



Signs and Symptoms



• Red erosion and ulceration of the vulva and inner aspects of the labia minora (may precede oral lesions by years; 33% of patients)

• Loss of the labia minora with scarring, adhesions, and narrowing common (complete obliteration of the vagina possible); dyspareunia and postcoital bleeding common

• Oral lesions—reticulated gray, lacy pattern (Wickham’s striae) with gingivitis (vulvar involvement in 50% of patients with oral lesions)


DIAGNOSTIC APPROACH



Differential Diagnosis:



• Amebiasis

• Behçet’s syndrome

• Candidiasis

• Dermatophyte infection

• Lichen sclerosus

• Neurodermatitis

• Pemphigus and pemphigoid (cicatricial or bullous type)

• Plasma cell vulvitis

• Psoriasis

• Squamous cell hyperplasia

• Systemic lupus erythematosus

• Vulvar intraepithelial neoplasia (VIN III)


Associated Conditions: Hair loss and a history of papular lesions on the skin (ankle, dorsal surface of the hands, and flexor surfaces of the wrists and forearms).


Workup and Evaluation



Laboratory:

Related posts:

  1. Anemia
  2. Toxic Shock Syndrome
  3. Uterine Anomalies: Bicornuate, Septate, and Unicornuate Uterus
  4. Breast: Intraductal Papilloma

Stay updated, free articles. Join our Telegram channel
Tags:
Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Lichen Planus

Full access? Get Clinical Tree
Get Clinical Tree app for offline access